In their case report the authors deal with the loss tissue injury of the proximal phalanx of the thumb caused by a circular saw. The first treatment on the day of the injury was carried out at the local clinic, the edges of the wound were trimmed and the residual small bone fragments were removed. Then suture was made of the dorsal aponeurosis and a K-wire was drilled in percutaneously through the distal phalanx into the base of the proximal phalanx in order to maintain the distance between the fragments. Wide-spectrum antibiotics were applied together with antitetanus-toxic injections and anti-gangrenous serum. After 9 weeks when the wound was healed per primam the patient was sent for further treatment to the central clinic. There they introduced extension through the nail of the thumb and left it there for 15 days. 11 weeks after the injury the patients was operated on. A bone graft was made from part of 6th rib and fixed to the residue of the base by a T-shaped plate. The distal phalanx was then transfixed to the bone graft by 2 crossed-K-wires. The wound healed per primam, K-wires were removed after 6 weeks. The grasping function of the hand was preserved, the residual motion was possible in the metacarpophalangeal joint of the thumb, interphalangeal arthrodesis was stable. The patient resumed his original job as a painter.

1 ortopedická klinika FVL UK Praha